原发性闭角型青光眼毛果芸香碱脂质体治疗的研究

Effects of topically applied pilocarpine liposome for primary angle closure glaucoma

目的研究1%毛果芸香碱脂质体对原发性闭角型青光眼的疗效和不良反应。方法原发性闭角型青光眼60例60只眼,其中对照组30例,30只眼;试验组30例,30只眼。用药前后,测量眼压及瞳孔直径,检查房角以及视力、结膜、角膜、前房、虹膜、瞳孔、晶体、眼底,A型超声测量前房深度、晶体厚度、眼轴,同时记录患者的自觉症状。1%毛果芸香碱滴眼液(对照组):每次滴眼1滴,约50μL,1d 4次;1%毛果芸香碱脂质体滴眼液(试验组):每次滴眼1滴,约50μL,1d 2次。结果2组患者性别、年龄、用药前眼压、瞳孔直径经统计学检验P>0.05,差异无显著性。2组患者滴药后各时间段的眼压均下降与用药前相比,差异有显著性(配对t检验,P<0.05);滴药后各时间段2组患者眼压相比,试验组眼压下降明显,差异有显著性(独立样本t检验,P<0.05)。2组患者滴药后各时间段的瞳孔值与用药前相比,瞳孔均有缩小,差异有显著性(配对t检验,P<0.05);滴药后各时间段2组瞳孔值相比,试验组瞳孔值小,差异有显著性(独立样本t检验,P<0.05)。每组用药前后以及2组患者用药前后前房深度、晶体厚度及眼轴长度,经统计学检验,无差异。脂质体组有7例发生滴药后短暂的表面刺痛感,2组未发现其他眼部和全身的不良反应。结论毛果芸香碱脂质体滴眼液应用于原发性闭角型青光眼的治疗,能减少滴眼次数,有效地控制眼压。

OBJECTIVE To study the effects of 1% pilocarpine liposome in the treatment of primary angle closure glaucoma （PACG）. METHODS Sixty patients with PACG were divided into 2 groups. Test group （30 patients） in age from 44 to 86 years received 1% pilocarpine liposome, and the control group（30 patients） in age from 56 to 90 years received 1% pilocarpine solution, The pupil diameter, intraocular pressure （ IOP）, anterior chamber angle, visual acuity, conjunctive, cornea, anterior chamber, iris, pupil, lens, fundus were measured at time intervals of beginning and 0, 5,1,2,4,6,8,12h on the first day and 8 A. M. on the second day to seventh day after drugs being applied. The investigation had a total duration of 7 days. Anterior chamber depth, lens thick, axial length of eye were measured by A ultrasound scan at time intervals of beginning and 6h. Test group received 1% pilocarpine liposome drop twice a day and control group received 1% pilocarpine solution drop 4 times a day. RESULTS The mean intraocular pressure, mean pupil diameter of 2 groups were not significant（ P 〉 0.05 ） at beginning. At beginning to any time intervals, hypotensive effect of each group was significant （ P 〈 0.05） ; Comparison of IOP of 2 groups was significant（ P 〈 0. 05 ） at same time intervals, The pupil constricted of each group was significant （ P 〈 0.05 ） at beginning to any time intervals ; Comparison of pupil constricted and pupil change of 2 groups were significant （P 〈 0.05） at same time intervals, Comparison of visual acuity was significant（ P 〈 0.05 ）. No side effects found except tingling sensation after eye drop instilled in the test group. CONCLUSION It shows that 1% pilocarpine liposome used only twice a day would lead to better control of PACG.